A transgender teenager’s gender-affirming care is at the heart of a potential class action lawsuit against Blue Cross Blue Shield of Illinois. According to the lawsuit, Blue Cross Blue Shield of Illinois refused to cover the gender-affirming care as part of an employer plan, which is a violation of the anti-discrimination provision in the Affordable Care Act.
Plaintiffs allege they are covered by an employer plan through Catholic Health Initiatives that is administered by Blue Cross. Blue Cross refused coverage citing a blanket exclusion for services related to gender transition. The lawsuit states that religious employers can assert an exemption from the Section 1557 of the Affordable Care Act but that Blue Cross is not a religious organization, and the plan is self-funded, so the exemption is not applicable.
The plaintiffs are looking to represent a class of other self-funded plans administered by Blue Cross with similar exclusions for the particular gender-affirming care.
The case is Pritchard v. Blue Cross Blue Shield of Illinois, U.S. District Court for the District of Washington, No. 3:20-cv-06145.
This blog is intended to provide information to the general public and to practitioners about developments that may impact Oregon class actions.